Transcoronary Ablation Of Septal Hypertrophy Research Articles

Sex-Related Differences among Adults with Hypertrophic Obstructive Cardiomyopathy Undergoing Transcoronary Ablation of Septal Hypertrophy.

(1) Background: The transcoronary ablation of septal hypertrophy (TASH) is an established therapy for hypertrophic obstructive cardiomyopathy (HOCM). Previous studies on this topic are characterised by a consistent male predominance and show a worse prognosis in females. (2) Methods: This study is a retrospective analysis of all TASH procedures conducted between 2006 and 2021 at a tertiary academic centre. A solution of 75 µm microspheres (Embozene®, Boston Scientific, Marlborough, MA, USA) was used as an embolising agent. The outcomes of interest were left ventricular outflow tract (LVOT) gradient reduction and symptom improvement among males vs. that among females. Secondarily, we analysed the sex-related differences in procedural safety outcomes and mortality. (3) Results: The study population consisted of 76 patients, with a median age of 61 years. Females comprised 57% of the cohort. We observed no sex-related differences in the baseline LVOT gradients at rest or under provocation (p = 0.560 and p = 0.208, respectively). Females were significantly older at the time of the procedure (p < 0.001), had lower tricuspid annular systolic excursion (TAPSE) (p = 0.009), presented a worse clinical status according to the NYHA functional classification (for NYHA ≥ 3, p < 0.001), and were more often on diuretics (p < 0.001). We did not observe sex-related differences in absolute gradient reduction at rest (p = 0.147) and under provocation (p = 0.709). There was a reduction in the NYHA class by a median value of 1 (p = 0.636) at follow-up for both sexes. Postprocedural access site complications were documented in four cases (two of which concerned females), and complete atrioventricular block was noted in five patients (three of which concerned females). The 10-year survival rates were comparable between the sexes (85% in females and 88% in males). The female sex was not associated with enhanced mortality according to multivariate analysis after adjusting for the confounding variables (HR 0.94; 95% CI 0.376-2.350; p = 0.895), but we observed age-related differences in long-term mortality (HR 1.035; 95% CI 1.007-1.063; p = 0.015). (4) Conclusions: TASH is safe and effective in both sexes, irrespective of their clinical differences. Women present at an advanced age and with more severe symptoms. An advanced age at the time of the intervention is an independent predictor of mortality.

Asymmetric septal hypertrophy with left ventricular outflow tract obstruction treated with transcoronary ablation of septal hypertrophy: a case report

Asymmetric septal hypertrophy with left ventricular outflow tract obstruction treated with transcoronary ablation of septal hypertrophy: a case report

P2588A comparative analysis of circulating non-coding RNAs versus protein biomarkers in the detection of myocardial injury

Abstract Background Non-coding RNAs (ncRNAs), including microRNAs (miRNAs), circular RNAs (circRNA) and long non-coding RNAs (lncRNA), have been implicated as novel cardiac biomarkers, but no comparative analysis has been performed on their release kinetics and detection range in myocardial injury without confounding by heparin. Purpose To assess the release kinetics of different ncRNA species in heparinase-treated plasma and serum samples in comparison with protein biomarkers for myocardial injury, including troponin and cardiac myosin binding protein C (cMyC). Methods and results Screening of 158 circRNAs and 21 lncRNAs in human cardiac tissue identified 12 circRNAs and 11 lncRNAs as potential biomarkers with cardiac origin. Two cardiac-enriched miRNAs (miR-208b and miR-499) and two muscle-enriched miRNAs (miR-1 and miR-133a) as well as 7 further well-known miRNAs with good detectability in plasma/serum were included. To compare the expression levels of ncRNAs with established and novel protein biomarkers (cardiac troponins and cMyC, respectively), human myocardial tissue was spiked into plasma. At low spike-in concentrations, significantly higher regression coefficients were observed for all ncRNA species. Serial plasma and serum samples were obtained of patients undergoing transcoronary ablation of septal hypertrophy (TASH). Heparinase-treatment resolved dense correlation network clusters by removing spurious correlations between miRNAs in non-heparinase-treated samples. After TASH, muscle-enriched miRNAs showed a steeper increase at an earlier time point than cardiac-enriched miRNAs. Putative cardiac lncRNAs, including LIPCAR, did not rise after TASH, refuting a predominant cardiac origin. Cardiac circRNAs remained below detectability. In a validation cohort of patients presenting with acute myocardial infarction, the release kinetics of ncRNAs was compared with cardiac troponins and cMyC. While receiver operating characteristic analyses revealed noninferiority of cardiac-specific miRNAs to high-sensitive cardiac troponin, miRNAs failed to identify cases presenting with low troponin values. Validating previous reports, cMyC showed better baseline detectability and a steeper rise at early time points after MI. Conclusions We assessed ncRNAs as biomarkers for myocardial injury after heparinase-treatment. MiRNAs emerged as the most promising candidates to integrate ncRNAs with protein biomarkers. The release kinetics of miRNAs is different from cardiac proteins, but the sensitivity of current miRNA detection is inferior to high-sensitive protein assays. We validate recent reports of cMyC showing properties of a very sensitive biomarker for the early detection of myocardial injury. Acknowledgement/Funding SCHU 2983/1-1 and SCHU 2983/1-2; FS/16/32/32184; FS/13/18/30207; 81Z0710102; CH/16/3/32406; RG/16/14/32397

Impact of Myocardial Contrast Echocardiography during Intra-Procedural Septal Perforator Section for Trans-Coronary Ablation of Septal Hypertrophy

Impact of Myocardial Contrast Echocardiography during Intra-Procedural Septal Perforator Section for Trans-Coronary Ablation of Septal Hypertrophy

Trans-Coronary Ablation of Septal Hypertrophy (TASH) in Hypertrophic Obstructive Cardio-Myopathy (HOCM): Acute and Long-Term Safety and Efficacy Outcome from a Single Center Experience

Trans-Coronary Ablation of Septal Hypertrophy (TASH) in Hypertrophic Obstructive Cardio-Myopathy (HOCM): Acute and Long-Term Safety and Efficacy Outcome from a Single Center Experience

Cysteine-rich angiogenic inducer 61 (Cyr61): a novel soluble biomarker of acute myocardial injury improves risk stratification after acute coronary syndromes.

We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls. Cyr61 levels were determined in human serum using an enzyme-linked immunosorbent assay. Cohorts of ACS (n = 2168) referred for coronary angiography, stable coronary artery disease (CAD) (n = 53), and hypertrophic obstructive cardiomyopathy (HOCM) patients (n = 15) served to identify and evaluate the diagnostic and prognostic performance of the biomarker. Cyr61 was markedly elevated in ST-elevation myocardial infarction patients compared with non-ST-elevation myocardial infarction/unstable angina or stable CAD patients, irrespective of whether coronary thrombi were present. Cyr61 was rapidly released after occlusion of a septal branch in HOCM patients undergoing transcoronary ablation of septal hypertrophy. Cyr61 improved risk stratification for all-cause mortality when added to the reference GRACE risk score at 30 days (C-statistic 0.88 to 0.89, P = 0.001) and 1 year (C-statistic 0.77 to 0.80, P < 0.001) comparable to high-sensitivity troponin T (30 days: 0.88 to 0.89, P < 0.001; 1 year: 0.77 to 0.79, P < 0.001). Similar results were obtained for the composite endpoint of all-cause mortality or myocardial infarction. Conversely, in a population-based case-control cohort (n = 362), Cyr61 was not associated with adverse outcome. Cyr61 is a novel early biomarker reflecting myocardial injury that improves risk stratification in ACS patients.

Release kinetics of high-sensitivity cardiac troponins I and T and troponin T upstream open reading frame peptide (TnTuORF) in clinically induced acute myocardial infarction

Context: Troponin T upstream open reading frame peptide (TnTuORF) may be useful as a novel biomarker in acute cardiac syndromes.Objective: The study examined the early release kinetics of TnTuORF.Materials and methods: We analyzed the time course of the release of cardiac troponins I and T and TnTuORF in patients (n = 31) with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH).Results: Fifteen minutes after TASH, the levels of both troponins increased significantly (cTnT median: 18 ng/L versus 27 ng/L; cTnI median: 15 ng/L versus 25 ng/L). TnTuORF showed no variation.Discussion: We observed a significantly greater increase in cTnI compared with cTnT.Conclusion: Our results demonstrate that troponin assays allow early detection of myocardial injury, whereas TnTuORF levels remain unchanged in this setting.

The Impact of Transcoronary Ablation of Septal Hypertrophy on Diastology in Hypertrophic Obstructive Cardiomyopathy

The Impact of Transcoronary Ablation of Septal Hypertrophy on Diastology in Hypertrophic Obstructive Cardiomyopathy

Reference Values and Release Kinetics of B-Type Natriuretic Peptide Signal Peptide in Patients with Acute Myocardial Infarction.

The signal peptide for human B-type natriuretic peptide preprohormone (BNPsp), which is released from cardiomyocytes, is increased in plasma of patients with acute myocardial infarction (AMI); however, its exact release kinetics have not been defined. We measured BNPsp and high-sensitivity cardiac troponin T (hs-cTnT) in a reference group of individuals without structural heart disease (n = 285) and determined the release kinetics of these biomarkers in patients (n = 29) with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH), a procedure allowing exact timing of onset of iatrogenic AMI. Blood samples were collected before TASH and at numerous preselected time points after TASH. The reference median BNPsp concentration was 53.4 pmol/L [interquartile range (IQR) 47.0-61.0; 95th percentile 85.9 pmol/L; 99th percentile 116.3 pmol/L]. Baseline concentrations in patients undergoing TASH were higher than in the reference group [91.9 pmol/L (IQR 62.9-116.4); P < 0.0001]. BNPsp increased significantly, peaking at 15 min after induction of AMI [149.6 pmol/L (109.5-204.9) vs baseline; P = 0.004] and declining slowly thereafter, falling below the preprocedural value after 8 h (P = 0.014). hs-cTnT increased significantly 15 min after induction of AMI [26 ng/L (19-39) vs 18 ng/L (11-29); P = 0.001] and remained high at all later time points. BNPsp concentrations increased immediately after AMI induction, providing early evidence of myocardial injury. The release kinetics of BNPsp differed from those of hs-cTnT. These findings provide information that should help in establishing the diagnostic value of BNPsp in the setting of early AMI.

Severe Gastrointestinal Bleeding in a Patient With Subvalvular Aortic Stenosis Treated With Thalidomide and Octreotide: Bridging to Transcoronary Ablation of Septal Hypertrophy

Gastrointestinal bleeding (GB) due to angiodysplasias can cause severe, recurrent bleeding, especially in elderly patients. Angiodysplastic bleedings in the gastrointestinal tract have been associated with aortic stenosis and, more recently, hypertrophic obstructive cardiomyopathy, caused by an acquired coagulopathy known as Heyde’s syndrome. Multiple factors are involved in the pathogenesis of angiodysplastic bleeding including genetic factors and increased levels of vascular intestinal growth factor at tissue levels. Endoscopic coagulation therapy is the primary treatment but often fails to resolve bleeding, especially in patients with large numbers of angiodysplasias. In patients with aortic stenosis and GB, the main treatment is aortic valve replacement but the patients may be unfit to undergo surgery due to the complicating anemia. In this case story, we present a patient with severe, GB due to hypertrophic subvalvular obstructive cardiomyopathy. Endoscopic procedures with argon beaming were performed without effect on bleeding. The patient was treated with a combination of both thalidomide and octreotide. Within 3 months, the patient recovered from the anemia and was able to undergo transcoronary ethanol ablation. No further bleeding episodes occurred, and thalidomide and octreotide were arrested. To our knowledge, this case report is the first to describe how this new drug combination therapy is an effective treatment of GB from angiodysplasias and can be used to bridge to surgical or endovascular treatment.

Release kinetics of inflammatory biomarkers in a clinical model of acute myocardial infarction.

Inflammation in the setting of acute myocardial infarction (MI) has been linked to risk stratification; however, the release kinetics of inflammatory biomarkers in patients with acute MI has been difficult to establish. The aim of this study was to determine the kinetics of changes in the levels of several biomarkers specifically linked to inflammation after transcoronary ablation of septal hypertrophy, a procedure that mimics acute MI. We analyzed release kinetics of C-reactive protein, high-sensitivity C-reactive protein, interleukin-6, soluble CD40 ligand, and peripheral blood leukocyte subsets in patients (n=21) undergoing transcoronary ablation of septal hypertrophy. Blood samples were collected before transcoronary ablation of septal hypertrophy and at various times after transcoronary ablation of septal hypertrophy. Serum levels of C-reactive protein were increased at 24 hours (1.0 mg/dL [interquartile range [IQR], 0.7-1.75] versus 0.2 mg/dL [IQR, 0.1-1.05] at baseline [BL]; P<0.001), whereas high-sensitivity C-reactive protein increased as early as 8 hours (2.68 mg/L [IQR, 1.23-11.80] versus 2.17 mg/L [IQR, 1.15-5.06] at BL; P=0.002). Interleukin-6 was significantly increased at 45 minutes (2.59 pg/mL [IQR, 1.69-5.0] versus 1.5 pg/mL [IQR, 1.5-2.21] at BL; P=0.002), and soluble CD40 ligand was significantly decreased at 60 minutes (801.6 pg/mL [IQR, 675.0-1653.5] versus 1750.0 pg/mL [IQR, 1151.0-2783.0] at BL; P=0.016). Elevated counts of polymorphonuclear neutrophils were detectable at 15 minutes, with a significant increase at 2 hours (6415 cells/μL [IQR, 5288-7827] versus 4697 cells/μL [IQR, 2892-5620] at BL; P=0.004). Significant monocytosis was observed at 24 hours (729 cells/μL [IQR, 584-1344] versus 523 cells/μL [IQR, 369-701] at BL; P=0.015). Interleukin-6 and neutrophil granulocytes showed a continuous rise at all prespecified time points after induction of MI. Our results provide valuable additional evidence of the diagnostic value of inflammatory biomarkers in the setting of early acute MI.

Release kinetics of early ischaemic biomarkers in a clinical model of acute myocardial infarction

ObjectiveTo determine the release kinetics of different biomarkers with potential as novel early ischaemic biomarkers in patients with acute coronary syndrome (ACS); it is difficult to establish the detailed release...

Cardiac tamponade due to coronary perforation during percutaneous interventions successfully treated with microspheres

In recent years, new techniques and materials in interventional cardiology have improved patient safety significantly. This led to the ability to perform more and more complex coronary interventions with a minimal risk for relevant complications. However, perforation of distal coronary vessels by guide wires is still observed and can lead to a life-threatening pericardial tamponade. Various treatment options have been described but management of this particular complication remains a challenge for the interventional cardiologist. So far, the treatment of choice for many cardiologists is the application of coils [1, 2]. But coils have some major disadvantages; they are sometimes difficult to position and are often not routinely available in cath labs. Other proposed methods include long inflation of over-the-wire balloons which is easy to handle and can be considered as a temporary solution to gain time, but is often not sufficient to stop the bleeding [3]. Implantation of covered stents can also be considered, but is not suitable in small vessels or lesions not reachable with a stent for other reasons [4, 5]. Administration of protamine might facilitate measures to seal a coronary perforation but might also lead to intracoronary thrombus formation or even stent thrombosis [6]. Microspheres are small spherical particles made of various materials with diameters ranging between 1 and 1,500 lm. Such particles are used for a broad spectrum of percutaneous interventions. They found their way into interventional cardiology as an alternative to ethanol for transcoronary ablation of septal hypertrophy (TASH) in hypertrophic obstructive cardiomyopathy (HOCM) [7]. Despite the fact that some authors suggested the use of different kinds of microspheres for coronary perforation, this technique did not find its way into clinical routine so far [8, 9]. This might partially be due the fact that the optimal size and material of microspheres remain uncertain. Patient #1 was admitted to the emergency department with ST-elevation myocardial infarction and was transferred to the cath lab immediately after admission. Emergency coronary angiography revealed an ostial occlusion of the left circumflex artery (LCX) which was treated with balloon angioplasty and implantation of an everolimus eluting coronary stent. For this purpose, a PT Graphix guide wire was placed distally in a marginal branch. The patient was provided with a loading dose of aspirin and ticagrelor. In addition to that, due to a heavy thrombus burden, abciximab was administered intravenously. After successful revascularization, the patient was referred to the intensive care unit for further surveillance. Two hours later the patient became hemodynamically unstable and had to be treated with catecholamines. Echocardiographic evaluation revealed cardiac tamponade as the underlying cause. Pericardial paracentesis was performed immediately and led to hemodynamic stabilization by drainage of 500 ml blood. As a coronary perforation seemed the most likely cause, coronary angiography was performed, showing a leak of contrast dye into the pericardium at the marginal branch of the LCX in which the wire was positioned during the prior intervention. Occlusion of the lesion by balloons did not lead to a sustained sealing. Therefore, decision was made to inject in total 3 ml of 75 lm Embozene microspheres (CeloNova BioSciences, San Antonio, TX, USA) F. Meincke (&) K.-H. Kuck M. W. Bergmann Department of Cardiology, Asklepios Klinik St. Georg, Lohmuehlenstrasse 5, 20099 Hamburg, Germany e-mail: f.meincke@yahoo.com

Release kinetics of circulating cardiac myosin binding protein-C following cardiac injury.

Diagnosis of myocardial infarction (MI) is based on ST-segment elevation on electrocardiographic evaluation and/or elevated plasma cardiac troponin (cTn) levels. However, troponins lack the sensitivity required to detect the onset of MI at its earliest stages. Therefore, to confirm its viability as an ultra-early biomarker of MI, this study investigates the release kinetics of cardiac myosin binding protein-C (cMyBP-C) in a porcine model of MI and in two human cohorts. Release kinetics of cMyBP-C were determined in a porcine model of MI (n = 6, pigs, either sex) by measuring plasma cMyBP-C level serially from 30 min to 14 days after coronary occlusion, with use of a custom-made immunoassay. cMyBP-C plasma levels were increased from baseline (76 ± 68 ng/l) at 3 h (767 ± 211 ng/l) and peaked at 6 h (2,418 ± 780 ng/l) after coronary ligation. Plasma cTnI, cTnT, and myosin light chain-3 levels were all increased 6 h after ligation. In a cohort of patients (n = 12) with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy, cMyBP-C was significantly increased from baseline (49 ± 23 ng/l) in a time-dependent manner, peaking at 4 h (560 ± 273 ng/l). In a cohort of patients with non-ST segment elevation MI (n = 176) from the SYNERGY trial, cMyBP-C serum levels were significantly higher (7,615 ± 4,514 ng/l) than those in a control cohort (416 ± 104 ng/l; n = 153). cMyBP-C is released in the blood rapidly after cardiac damage and therefore has the potential to positively mark the onset of MI.

Release kinetics of N-terminal pro-B-type natriuretic peptide in a clinical model of acute myocardial infarction

BackgroundN-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP) is elevated in patients with acute myocardial infarction (AMI) thus providing both diagnostic information and prognostic information. The aim of the present study was to determine the time course of NT-proBNP release in patients undergoing transcoronary ablation of septal hypertrophy (TASH) a procedure mimicking AMI. MethodsWe analyzed the release kinetics of NT-proBNP in 18 consecutive patients with hypertrophic obstructive cardiomyopathy undergoing TASH. Serum samples were collected prior to and at 15, 30, 45, 60, 75, 90, and 105min, and 2, 4, 8, and 24h after TASH. ResultsNT-proBNP concentrations showed a continuous increase during the first 75min with a significant percent change compared to baseline value already 15min after TASH (105.6% [IQR 102.2–112.7]; P<0.001). All patients had a significant increase of NT-proBNP at 45min (range of percent increase [min–max]: 103.5–137.2%; range of absolute increase [min–max]: 23.5–304.0ng/L). NT-proBNP concentrations decreased below the baseline value until the 8th h after initiation of myocardial infarction. ConclusionNT-proBNP concentration increases immediately after induction of myocardial infarction proving early evidence of myocardial injury despite the decrease of the left ventricular wall stress due to the TASH related reduction of the left ventricular outflow gradient.

Keynote Lecture-Transmitral hypertrophic obstructive cardiomyopathy (HOCM) repair.

Hypertrophic obstructive cardiomyopathy (HOCM) is a heterogenous disease causing obstruction of the left and/or right ventricular outflow tract (LVOT and/or RVOT, respectively). The main symptoms include dyspnea on exertion and syncope, and in severe cases, subsequent development of heart failure symptoms with end stage heart failure occurs. In a certain number of patients, surgical intervention is required since pharmacological and/or interventional treatment using transcoronary ablation of septal hypertrophy (TASH) does not relieve symptoms. The primary goal of any surgical technique is to relieve LVOT obstruction, avoid the occurrence and/or recurrence of systolic anterior movement (SAM) of the anterior mitral leaflet (AML) and-if present-reduce mitral valve (MV) regurgitation. Depending on the configuration of LVOT obstruction, myectomy with/without MV replacement has been the "gold standard" in surgical treatment of HOCM. However, considering the known disadvantages of artificial valves, MV preserving techniques will improve postoperative outcomes and decrease major adverse events in the long term. We describe the currently available operative strategies for treatment of HOCM. Special consideration is given to minimally invasive access with subaortic LVOT myectomy and complete resuspension of the AML to treat both HOCM and MV regurgitation.

The long‐term outcomes of transcoronary ablation of septal hypertrophy compared to surgical myectomy in patients with symptomatic hypertrophic obstructive cardiomyopathy

The aim of this study was to compare the long-term outcomes of transcoronary ablation of septal hypertrophy (TASH) with open surgical myomectomy (SM) in patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM). We reviewed patients who underwent either procedure at our institution. The demographics, clinical outcomes, echocardiographic parameters, and complications were compared. Seventy patients with HOCM were treated with either TASH (n = 47, 26 male) or SM (n = 23, 10 male). Compared to those treated with SM, patients undergoing TASH were older (57+/- 14.7 years versus 47 +/- 20.6 years, P = 0.021) and more symptomatic. A higher proportion of patients had syncope as a presenting feature in the TASH group compared to the SM group (57.5% vs. 17.4%, P = 0.002) respectively. They were also more likely to be in New York Heart Association (NYHA) class III/IV compared to the patients who underwent SM (85.1% vs. 39.1%; P < 0.001). Patients were followed for a mean period of 43 months (TASH) and 46 months (SM). Repeat procedures were more common in the TASH group (17% vs. 0%, P = 0.04) but mitral valve replacement was more common in the SM group (0% vs. 8.7%, P = 0.105). Symptom improvement, the rate of complications and all cause mortality rates were similar in both groups. TASH compares favorably with surgical myectomy with regard to symptom resolution, rate of complications and mortality in a tertiary referral centre and should be seen as an attractive alternative to surgical myectomy in the appropriate patient population.

Alcohol Septal Ablation in a Patient With Hypertrophic Obstructive Cardiomyopathy

TRANSCORONARY ABLATION of septal hypertrophy (TASH), first introduced in 1994, has become an important option for treating symptomatic hypertrophic obstructive cardiomyopathy (HOCM), a rare disorder. The first septal branch of the left anterior descending artery (LAD) is located and 96% alcohol is instilled to induce an artificial myocardial infarction and necrosis at the base of the hypertrophied septum. This resolves the left ventricular outflow tract (LVOT) gradient due to its widening, restricted septal excursion, decreased mitral regurgitation, and subsequent global negative ventricular remodeling. Despite its growing acceptance, some risks are inherent to the procedure. Here, the authors describe the management of a case of TASH complicated by complete atrioventricular (AV) block.

Release kinetics of circulating micrornas in patients undergoing transcoronary ablation of septal hypertrophy

Background: MicroRNAs (miR) have been proposed as novel biomarkers in patients with cardiovascular disease. The release kinetics of miRs in patients with acute myocardial infarction (AMI) are difficult to establish. Methods: We analyzed the release kinetics of circulating muscle-enriched miRs (miR-1, miR-21, miR-208a, miR-133a) measured by TaqMan polymerase chain reaction in patients with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH), a procedure mimicking AMI. Consecutive patients (n=21) undergoing TASH were included. Serum samples were collected prior to and at 15, 30, 45, 60, 75, 90, and 105 min, and 2, 4, 8, and 24 h after TASH. Results: Circulating concentrations of miR-1 significant increased already after 15 min (>4-fold; P 60-fold; P 50-fold change) and decreases afterwards (30-fold change at 24 hours). MiR-208a concentrations rise the first 75 min (>2-fold; P=0.01) without further increase during all time points. Serum concentrations of miR-1 positively correlated with the hs-cTnT release during the first 120 min after induction of myocardial infarction (r2=0.95; P<0.001). Similar correlations could be observed for miR-133a (r2=0.97; P<0.001). The serum concentrations of miR-21 and miR-208a did not show any significant correlation with hs-cTnT. Conclusion: miR-1, miR-208a, and miR-133a continuously rose during the first 4 h after induction of AMI. In particular, miR-1 and miR-133a were significantly increased at early time points. These results demonstrate the release kinetics of miRNAs, which are helpful for developing their potential use as biomarkers in patients with acute coronary syndrome.

Release kinetics of early ischemic biomarkers in patients undergoing transcoronary ablation of septal hypertrophy

Release kinetics of early ischemic biomarkers in patients undergoing transcoronary ablation of septal hypertrophy